A client sat in my office last Tuesday, crying about how broken she was, how everyone else seemed to have life figured out while she was falling apart. She apologized for crying. Again. Then she apologized for apologizing.

I wanted to tell her something I'm not supposed to say: "I literally had a panic attack in my car before our session because I'm worried about my own kid's mental health and feel like I'm failing as a parent despite having a PhD in psychology."

But I didn't. Because there's an unwritten rule in my profession: maintain the professional boundary. Keep the mystique. Let clients believe we have it all figured out.

After fifteen years as a practicing psychologist, I'm breaking that rule. Not to be unprofessional, but because the gap between what we know and what we're allowed to say is harming the very people we're trying to help.

The Illusion We're Paid to Maintain

Here's the first secret: We're not supposed to shatter the illusion that we're somehow above the human struggles you bring to us. The therapeutic relationship requires a certain professional distance, and that's appropriate. But somewhere along the way, that distance became a performance of perfection.

Clients come into therapy believing their therapist has achieved some enlightened state of mental health. They think we've transcended anxiety, figured out relationships, and mastered emotional regulation.

The truth? Most therapists I know are in therapy themselves. We struggle with the same existential dread, relationship issues, and self-doubt as everyone else. The difference is we have frameworks for understanding it and tools for managing it.

But we're still human. Still struggling. Still learning.

What We Really Think During Sessions

People always ask me what therapists are really thinking during sessions. Here's the honest answer:

Sometimes, we're genuinely moved by your courage and insight. Other times, we're mentally reviewing research to figure out the best intervention for what you're describing. Occasionally, we're worried we just said something that might have been unhelpful.

And yes, sometimes we're distracted by our own problems. We're thinking about the argument we had with our partner that morning or the concerning email from our kid's teacher.

Does that mean we're not present or caring? Absolutely not. It means we're human beings doing human work. The goal isn't perfect presence — it's genuine presence, which includes acknowledging when our attention wavers and intentionally bringing it back.

The Patterns We See That You Don't

After thousands of hours in the therapy room, patterns emerge that most clients don't see. Here are the ones that show up most consistently:

The people who apologize the most are usually the ones who have the least to apologize for. If you constantly say "sorry" in therapy, you're probably someone who was trained to take up as little space as possible. The work isn't learning when to apologize more — it's learning when to stop.

The "high-functioning" clients are often the most at risk. You're holding down a demanding job, maintaining relationships, looking fine from the outside — and completely falling apart internally. Nobody checks on you because you seem so capable. This is dangerous.

Insight doesn't equal change. I have clients who can brilliantly analyze why they do what they do, cite attachment theory, and explain their childhood wounds. But they still repeat the same patterns because understanding something intellectually is completely different from changing it emotionally and behaviorally.

The breakthrough moment you're waiting for probably won't come. Therapy isn't like the movies. There's rarely one dramatic revelation that changes everything. Real change is boringly incremental — tiny shifts in how you respond to situations, small moments of choosing differently.

Your therapist notices when you're performing. We can tell when you're telling us what you think we want to hear versus what's actually true. The sooner you drop the performance, the sooner we can do real work.

The Diagnosis Dilemma

Here's something controversial: sometimes I don't tell clients their diagnosis immediately, or at all. Not because I'm hiding information, but because I've seen how diagnostic labels can become identity.

Insurance requires a diagnosis for coverage. The medical model demands categorization. But humans are messy, complex, and constantly evolving. That depression diagnosis you got at 22 might not fit you at 35, but you've built your entire identity around "being depressed."

I've had clients come in saying, "I have anxiety" as though it's a permanent characteristic rather than a set of symptoms they're experiencing. The subtle difference matters enormously.

Diagnoses can be helpful frameworks. They can also become prisons. Part of my job is figuring out which they'll be for each person.

What Actually Heals (And What Doesn't)

After all these years, I've learned that what heals people isn't always what we're taught in graduate school. Here's what I've observed:

Healing happens in a relationship, not in techniques. I can use the perfect intervention from the best evidence-based therapy, but if we don't have a genuine connection, it won't work. Conversely, sometimes the most healing moments happen when I simply sit with someone in their pain without trying to fix anything.

The clients who improve the most are usually the ones who show up consistently, not the ones who have the most insight. There's something about the ritual of coming to therapy week after week that creates change, regardless of what we talk about.

Medication isn't giving up — sometimes it's what makes therapy possible. I've seen too many clients torture themselves trying to think their way out of brain chemistry issues. Sometimes you need medication to stabilize enough to do the therapeutic work.

Trauma work is about building safety, not just processing memories. Everyone wants to dive straight into trauma processing, but if you don't have emotional regulation skills and a sense of safety first, you're just re-traumatizing yourself.

The relationship patterns you have with your therapist mirror your other relationships. If you're afraid to disappoint me, you're probably afraid to disappoint everyone. If you test whether I'll abandon you, you're probably testing everyone else, too. The therapy relationship is a laboratory for understanding and changing your relational patterns.

The Things We Can't Say

There are moments in therapy where I know something the client isn't ready to hear. This is the most frustrating part of my job.

I can see that your relationship is abusive, but you're not ready to leave, and if I push too hard, you'll just stop coming to therapy.

I can see that your people-pleasing is destroying your mental health, but you're still getting too much validation from being "the helpful one" to give it up.

I can see that your anxiety is actually protecting you from dealing with deeper depression, and addressing one means confronting the other.

I can see that you're repeating your parents' patterns with your own kids, and it breaks my heart.

But I can't just tell you these things. Therapy doesn't work that way. People change when they're ready, not when their therapist is ready for them to change.

The art of being a therapist is planting seeds and trusting they'll grow when the conditions are right, even if I'm not there to see it.

The Mythology of "Fixing" People

Let me be clear about something: I don't fix people. I can't fix people. Nobody can fix another human being.

What I can do is create a space where you feel safe enough to look at the parts of yourself you've been avoiding. I can offer frameworks for understanding your experience. I can teach you skills for managing difficult emotions. I can challenge the stories you tell yourself that keep you stuck.

But the actual work of changing? That's all you.

Every client who makes meaningful progress does so because of their own courage, commitment, and willingness to sit with discomfort. I'm just the guide. They're the ones climbing the mountain.

When clients thank me for "fixing" them, part of me wants to accept the gratitude. But the more honest part wants to hand them a mirror and say, "Look at what you did. This was you."

The Clients Who Haunt Me

There are clients I still think about years later. Not because they had the most dramatic stories, but because something about their struggle touched something in mine.

The young man who reminded me of myself at his age — anxious, perfectionistic, terrified of disappointing people.

The mother, who was trying so hard to break generational trauma patterns and felt like she was failing.

The executive who looked successful from the outside but felt hollow inside.

I think about them because their struggles are universal. Because in helping them, I'm also helping past versions of myself. Because their healing reminds me that change is possible.

And I wonder if they know how much they taught me.

What We Wish Clients Understood

If I could tell every client something without the constraint of therapeutic neutrality, here's what it would be:

You're not "too much." The clients who worry most about being too needy, too emotional, too complicated are never actually too much. The ones who are genuinely too demanding usually don't worry about it.

Progress isn't linear. You'll have good weeks and terrible weeks. The terrible weeks don't erase the progress you've made. They're part of the process.

Your therapist isn't judging you. Whatever you did, thought, or felt — I promise I've heard worse. And even if I haven't, my job isn't to judge. It's to understand.

It's okay to disagree with your therapist. If something I say doesn't resonate, tell me. Therapy works best when it's collaborative, not when you're passively receiving wisdom from on high.

Ending therapy doesn't mean you failed. Sometimes people grow out of therapy. Sometimes they need a break. Sometimes the timing isn't right. That's all normal.

We're rooting for you. Even when you cancel appointments, show up late, or resist the work, we're still on your team. We became therapists because we believe in people's capacity for change.

The Ethical Tightrope

Everything I'm sharing here walks a careful line. There are things I know about therapy that could be helpful for people to understand, but there are also boundaries I need to maintain.

I'll never share identifying information about clients. I'll never violate confidentiality. I'll never use this platform to work through my own unprocessed issues at clients' expense.

But I also think the profession has become too precious about maintaining mystique. We've created a dynamic where therapists are supposed to be blank slates, and I'm not sure that always serves clients well.

Maybe knowing that your therapist is human too — that we struggle, that we don't have all the answers, that we're on our own journeys — makes therapy more accessible rather than less.

What I've Learned About Suffering

Fifteen years of sitting with people in their darkest moments has taught me things about suffering that I could never have learned from textbooks:

Suffering is democratic. It doesn't care about your intelligence, success, appearance, or virtue. The most accomplished people I know are often the most tormented.

People are astonishingly resilient. I've witnessed humans endure things I can barely imagine and still find ways to create meaning, connection, and joy.

The stories we tell ourselves about our suffering matter more than the suffering itself. Two people can experience similar trauma and have completely different outcomes based on the narrative they construct around it.

Healing is possible, but it's not linear, pretty, or permanent. It's messy, recursive, and requires more courage than most people realize.

The Question I Ask Myself

At the end of difficult sessions, I ask myself the same question: "Did I show up fully human today?"

Not "Did I use the right technique?" or "Did I say the perfect thing?" but "Was I genuinely present with this person's pain?"

Because here's what I've learned: people don't heal because their therapist is perfect. They heal because their therapist is human enough to sit with them in their humanity.

The therapeutic techniques matter. The training matters. The theory matters.

But what matters most is the willingness to be authentically present with another person's suffering without trying to fix it, minimize it, or run from it.

Why I'm Still Here

This work is exhausting. The vicarious trauma is real. The emotional labor is immense. There are days I question whether I'm making any difference at all.

But then a client tells me they set a boundary for the first time. Or they got through a difficult situation without falling apart. Or they realized they're not fundamentally broken.

And I remember why I do this.

Not because I have all the answers. Not because I'm some enlightened guru who's transcended human struggle.

But because I believe, deeply and completely, that people can change. That suffering doesn't have to be permanent. That with the right support and enough courage, humans are capable of remarkable transformation.

The Truth About Therapists

We're not gurus. We're not saints. We're not perfectly mentally healthy humans who have life figured out.

We're people who choose to sit with suffering for a living. Those who believe in the power of relationships to heal. Who've done enough of our own work to guide others through theirs.

We have our own therapists. Our own struggles. Our own moments of feeling like frauds.

But we show up anyway. Week after week, client after client, holding space for people's pain while managing our own.

That's not superhuman. It's just human.

And maybe that's the most important thing I can tell you: if someone as flawed and human as me can hold space for your suffering, then you can hold space for it too.

You don't need to be fixed. You need to be seen, understood, and supported in your own process of becoming.

That's what therapy is. That's what I do.

And that's what I wish everyone knew.

The therapy room is where we practice being human together. Your therapist isn't perfect — we're just a little further along the path, willing to walk beside you while you find your way.